Reputation Activity by Wuzzie

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I've asked this question over and over and nobody has answered it. Where would you draw the line? How bad does a nurse have to violate basic nursing standards before you'll agree that there is negligence that rises to the definition of criminal? I'm seriously interested in what that threshold would be.

If you read the previous thread here about this situation, and the CMS report (link is on page 14 of the previous thread) many of your above questions will be answered. This person's actions fell far below basic standards of acceptable nursing practice. That's why many of us are not calling it an "error" and no, it could not have been any of us.
I don't know if her intent was malicious or not. That's because I don't know what circumstances would make me play so fast and loose with patient safety. There's a time for solidarity and there's a time for accountability.

Awwww. Thank you for your kind words. I no longer fly but I keep current with my certs (those that I can) and I sure as heck hope I never see any of you in my current line of work. Even the ones who disagree with me. 🤗

Intermittent bubbling in the water seal chamber will be present if there is still an air-leak regardless of whether it’s on wall suction or not. It will be absent only if there is no longer an air-leak. Confusion was caused when the Pleur-Evac company developed a “dry suction control” chamber. They used to only have a “wet-suction control” chamber where the amount of suction was controlled by the level to which you filled the chamber with water. This was meant to have continuous bubbling. When facilities switched to the dry suction style with a dial some people got confused when they were told that there would be no more bubbling. Sadly this is because they don’t really have a complete understanding of how these systems work so they don’t actually know what the different chambers are for.

Yes. If a pulmonary air leak is still present you can expect to see intermittent bubbling in the water seal chamber that correlates with the patient’s expirations with or without suction. However, if there is continuous bubbling in the chamber and the device is hooked to suction you have a system leak and you need to check all of your connections. Who exactly is telling you differently?

But we don’t know if they had intent. Maybe they were really rushed. Maybe staffing was bad. Maybe they didn’t know any better. They were young. They were new. There should have been safeguards in place. Oh, they overrode them well it’s not their fault. Maybe they truly believed they were helping. Any of us could have pushed 2000MCG OF FENTANYL! They probably didn’t know that could kill a patient.
Sorry for the snark, I had a supremely craptastic day today but this is what we’ve come to folks. A whole profession hiding behind our lily-white reputations and feeling like we are above the law even when we violate the most basic of standards.

No they aren't. Her cavalier approach to medication administration is what's insulting. She didn't make one lapse in judgment. She literally messed up every single step of the way. When we are in nursing school we are taught that we need to be careful when administering medications because the wrong medication, route, timing and/or dose can harm a patient. This is a basic nursing principle that every single one of us comes out of school understanding. You don't just "forget" those kind of things. She was reckless in her practice and another human being was harmed. She needs to stand before a judge and explain herself. I understand your position and your apprehension, I really do, but we have to set a limit somewhere. I think this is the limit. We aren't above the law. This should be a wake up call to all of us that we need to scrutinize our practice and always, always do things the right way.

But we don’t know if they had intent. Maybe they were really rushed. Maybe staffing was bad. Maybe they didn’t know any better. They were young. They were new. There should have been safeguards in place. Oh, they overrode them well it’s not their fault. Maybe they truly believed they were helping. Any of us could have pushed 2000MCG OF FENTANYL! They probably didn’t know that could kill a patient.
Sorry for the snark, I had a supremely craptastic day today but this is what we’ve come to folks. A whole profession hiding behind our lily-white reputations and feeling like we are above the law even when we violate the most basic of standards.

But we don’t know if they had intent. Maybe they were really rushed. Maybe staffing was bad. Maybe they didn’t know any better. They were young. They were new. There should have been safeguards in place. Oh, they overrode them well it’s not their fault. Maybe they truly believed they were helping. Any of us could have pushed 2000MCG OF FENTANYL! They probably didn’t know that could kill a patient.
Sorry for the snark, I had a supremely craptastic day today but this is what we’ve come to folks. A whole profession hiding behind our lily-white reputations and feeling like we are above the law even when we violate the most basic of standards.

I can’t answer that because I don’t have an opinion on what her punishment should be. I don’t know if I even care if she doesn’t go to jail at all but I believe she should, at the very least, face a judge and explain herself. The courts can decide from there.

Yes in our case it was. In the Vandie case...no, I’m sorry it was just really unsafe nursing practice.
But that wasn’t the point of my posting it. I want people to realize that there IS a difference between system errors and poor nursing judgment. My issue with the Vandie nurse isn’t the med error. It is with the lack of standard observation after giving an IV push med. That is the worst thing she did in a long list of really stupid actions. It was reckless and she knew better.

She did not make a mistake. If she had properly observed the patient for the medication she THOUGHT she gave this patient would not be dead and I would have an entirely different opinion. She slammed 2mg of Versed and walked away. That is the recklessness that takes this way beyond a simple medication error!

Because one would think that a certified ICU nurse would understand the basic principle of giving IV push medications which is to monitor the patient after for response. Observation for a period of time after would have been sufficient. Full monitoring was not necessary. Had she waited even one minute she would have seen that the patient was not breathing. It appears she slammed the med and left. Vecuronium’s onset is almost immediate.
The med had been verified and was available in the patient’s profile 10 minutes before she tried to pull it.
At the time it happened she had two years of experience in the Vandie ICU and was certified as a CV-ICU nurse.
I don’t at all agree with the alarmist idea that every nurse is now going to be indicted for simple med errors. This was not just a med error. It was an egregious violation of all the standards which bind us as nurses.

But we don’t know if they had intent. Maybe they were really rushed. Maybe staffing was bad. Maybe they didn’t know any better. They were young. They were new. There should have been safeguards in place. Oh, they overrode them well it’s not their fault. Maybe they truly believed they were helping. Any of us could have pushed 2000MCG OF FENTANYL! They probably didn’t know that could kill a patient.
Sorry for the snark, I had a supremely craptastic day today but this is what we’ve come to folks. A whole profession hiding behind our lily-white reputations and feeling like we are above the law even when we violate the most basic of standards.

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